Compositions, devices, systems and methods relating to improvement of range of motion in joints

Abstract

Systems, devices and methods, etc., to prevent loss of range of motion or to increase range of motion in an articulating joint having or anticipated to have reduced range of motion due to injuries, medical conditions, surgical adhesions, etc., including increased range of motion after surgery compared to range of motion after such surgeries without administration of the medically acceptable fucan loads or dosages herein.

Description

COMPOSITIONS, DEVICES, SYSTEMS AND METHODS RELATING TO IMPROVEMENT OF RANGE OF MOTION IN JOINTSCROSS-REFERENCE TO RELATED APPLICATIONS

[0001] The present application claims the benefit of copending United States Provisional Patent Application Serial No. 63 / 550,022, filed February 5, 2024, which application is incorporated herein by reference in its entirety.BACKGROUND

[0002] Fucans (including fucoidan) are sulfated polysaccharides. In general terms, this means that they are molecules made up of a number of sugar groups, and also have sulfur atoms attached to the sugar groups. The main sugar group is called "fucose", which is sugar that has 6 carbon atoms and has the chemical formula C6H12O5. "Fucoidan" (or fucoidin) indicates fucans derived from brown algae (seaweed). Fucans can exist alone, or in a mixture of other sugars, for example in a mixture of sugars such as xylose, galactose, glucose, glucuronic acid and / or mannose. These other sugars may be extracted from the seaweed or other source with the fucan. Although fucans are currently derived from natural sources such as the brown algae (seaweeds), sea cucumbers, etc., mentioned herein, "fucan" includes polymer molecules having the chemical and structural motifs of the fucans as discussed herein regardless of the ultimate source(s) of the fucans.

[0003] Fucoidan can be obtained from a variety of species of brown algae including but not limited to: Adenocystis utricularis, Ascophyllum nodosum, Chorda filum, Cystoseirabies marina, Durvillaea antarctica, Ecklonia kurome, Ecklonia maxima, Eisenia bicyclis, Fucus evanescens, Fucus vesiculosis, Hizikia fusiforme, Himanthalia Elongata, Kjellmaniella crassifolia, Laminaria brasiliensis, Laminaria cichorioides, Laminaria hyperborea, Laminaria japonica, Laminaria sac- charina, Lessonia trabeculata, Macrocystis pyrifera, Pelvetia fastigiata, Pelvetia Canaliculata, Sac- charina japonica, Saccharina latissima, Sargassum stenophylum, Sargassum thunbergii, Sargas- sum confusum, Sargassum fusiforme and Undaria pinnatifida. These exemplary species are all from the taxonomic class Phaeophyceae and the majority of these species fall into the families of Fucales and Laminariaceae.

[0004] Fucans including fucoidan have been shown to be efficacious in treating a variety of different medical conditions. However, there has been no known disclosure of the use of medicallyacceptable fucans to increase the range of motion in highly articulable joints such as articulating joints that have a significantly limited range of motion compared to normal, including joints having severely limited ranges of motion. Thus, there has gone unmet a need for devices, systems, methods, etc., for medically acceptable fucan loads or dosages that increase range of motion in such joints.SUMMARY

[0005] The present systems, devices and methods, etc., are directed to prevent loss of range of motion or to increase range of motion in an articulating joint, i.e., to improvement in range of motion for patients having or anticipated to have reduced range of motion due to injuries, medical conditions, surgical adhesions, etc., including increased range of motion after surgery compared to range of motion after such surgeries without administration of the medically acceptable fucan loads or dosages herein.

[0006] The methods and medical devices, etc., herein are also directed to prevent or reduce the formation or reformation of tightened capsules, which are anatomical structures that are abnormally thickened. In the shoulder, tightened capsules are also called adhesive capsulitis. The formation of some tightened capsules can be idiopathic; and the cause of some tightened capsules is multi -factorial. The methods and medical devices, etc., herein are also directed to improvement in range of motion for patients having reduced range of motion due to thickened capsule and / or surgical adhesions, including increased range of motion after surgery to release the tightened capsule compared to range of motion after such surgeries without administration of the medically acceptable fucan.

[0007] Fucan loads or dosages can comprise 5 mg, 10 mg, 15 mg, 20 mg, 25 mg, 50 mg, 100 mg, 150 mg, 200 mg, 250 mg, 500 mg, 1000 mg, 1500 mg, 2000 mg, 2500 mg, or other loads or dosages as required. Concentrations of fucans in a medically acceptable solution such as a buffered physiological solution can comprise (in mg fucan / mL): 1 mg / mL, 2 mg / mL, 2.5 mg / mL, 5 mg / mL, 10 mg / mL, 15 mg / mL, 20 mg / mL, 25 mg / mL, 50 mg / mL, 100 mg / mL, 150 mg / mL, 200 mg / mL, 250 mg / mL, or in other concentrations and volumes as desired.

[0008] Suitable fucans include those shown in: PCT / CA2019 / 051025, filed July 24, 2019; PCT / CA2019 / 051026, filed July 24, 2019; PCT / CA2019 / 051027, filed July 24, 2019,PCT / CA2019 / 051030, filed July 24, 2019; PCT / CA2019 / 051028, filed July 24, 2019; PCT / CA2020 / 050294, filed March 5, 2020; PCT / CA2020 / 050295, filed March 5, 2020; and PCT / CA2019 / 051029, filed July 24, 2019. (Various references are set forth herein, including in the Cross-Reference To Related Applications, that discuss certain compositions, systems, apparatus, methods and other information; all such references are incorporated herein by reference in their entirety and for all their teachings and disclosures, regardless of where the references may appear in this application. Citation to a reference herein is not an admission that such reference constitutes prior art to the current application.)

[0009] Suitable fucans have passed, for example, at least Phase 1 safety clinical trials and pre- clinical ISO 10993 and other biocompatibility, safety and efficacy studies. Suitable fucans can be used, for example, in orthopedic surgeries, including knee, shoulder, elbow, ankle and hip joints.

[0010] The present methods, systems, devices, etc., provide safe medically-acceptable fucans and fucan compositions and loads or dosages suitable for medical and surgical applications (collectively, "range of motion increasing fucans" unless otherwise noted such as in the claims), and associated delivery methods and systems, etc., for increasing or improving the range of motion in a joint, including increased range of motion after surgery compared to range of motion after such surgeries without administration of the medically acceptable fucan loads or dosages herein. Such range of motion increasing fucans can be administered to a joint suspected of having or presenting with limited range of motion including severely limited ranges of motion. Such range of motion increasing fucans can be administered to a joint which is anticipated to have limited range of motion in the future including future concerns due to a specific, identified problem such as surgery or arthritis.

[0011] Such improvement in range of motion due to administering range of motion increasing fucans can occur in the course of treating diseases, infections, traumas, injuries, surgeries, reactions, and other medical conditions, all of which are collectively referred to as “medical conditions” hereafter, that occur in articulating joints in a patient, i.e., animal, including a human. Such improvement in range of motion can occur in the course of surgical intervention, or surgery, wherein the fucan can be administered before, during and after a surgical procedure to a joint within the surgical cavity. Such improvement in range of motion can occur in the course of manipulation under anesthesia or manipulation without anesthesia intervention, wherein the fucancan be administered before, during and after a manipulation under anesthesia or manipulation without anesthesia procedure to a joint undergoing such manipulation.

[0012] Joints suitable for treatment herein to improve a limited range of motion using the fucan compositions and methods herein are articulating joints, i.e., joints having significant range of motion such as mobile amphiarthrotic joint or diarthrotic joints, including monoaxial articulating joints and multiaxial articulating joints. See https: / / bio.libretexts.org / Courses / West_Hills_Col- lege_-_Lemoore / Human_Anatomy_Laboratory_Manual_(Hartline) / 10%3A_Articula- tions_(Joints)_and_Movements / l 0.01%3A_Arti culations_(Joints);https: / / louis. pressbooks. pub / humananatomyandphysiology l / chapter / l l -joints / #l l - L The specific joints included in the current application are as follows: joints of the head, neck and spine that have significant range of motion (e.g., Temporomandibular joint (jaw)), craniocervical junction (joints connecting the head and spine, also known as the craniovertebral junction), intervertebral joints (joints in the spine or connecting the spine to the pelvis), shoulders, elbows, wrists, hands and fingers, hips, knees, ankles, and feet and toes. Further joints / joint groups include 1) mobile cartilaginous joints, in which bones are connected by cartilage and have significant range of motion between adjacent bones, such as symphyses for intervertebral discs, and 2) synovial joints, which are freely movable joints containing synovial fluid, including hinge joints (e.g., elbow, humeroulnar, humeroradial knee, tibiofemoral, interphalangeal), ball-and-socket joints (e.g., shoulder, glenohumeral, hip, coxal), pivot joints (e.g., atlantoaxial joint, proximal radioulnar joint), gliding (plane) joints (e.g., intercarpal joints, intertarsal joints, zygapophy sial joints), saddlejoints (e.g., carpometacarpal joint of the thumb), condyloid (ellipsoid) joints (e.g., wrist or radiocarpal joint, metacarpophalangeal or knuckle joints).

[0013] In some aspects, the methods comprise increasing range of motion of an articulating joint having a limited range of motion or suspected of having a limited range of motion, or inhibiting or preventing decrease of range of motion of an articulating joint due to a specific identified cause. The methods can comprise:- identifying that the articulating joint has a limited range of motion,- selecting a therapeutically effective dose of a medically acceptable fucan composition to provide a selected therapeutically effective dose of a medically acceptable fucan sufficient to increase range or prevent decrease of motion in the articulating joint,- administering to the articulating joint the selected therapeutically effective dose of the medically acceptable fucan composition in order to increase or prevent decrease the range of motion of the articulating joint,

[0014] In some embodiments, the therapeutically effective dose of the selected medically acceptable fucan is sufficient to significantly increase, or prevent decrease of, range of motion in the articulating joint.

[0015] The therapeutically effective dose of the selected medically acceptable fucan can increase range of motion, or prevent decrease of, in the articulating joint compared to an untreated joint by at least 10 degrees, 15 degrees, 20 degrees, 25 degrees, degrees, 30 degrees, 35 degrees, 40 degrees, 45 degrees, 50 degrees, 55 degrees, 60 degrees, 70 degrees, 80 degrees, 90 degrees or 100 degrees. The therapeutically effective dose of the selected medically acceptable fucan can increase range of motion in the articulating joint compared to an untreated joint by at least 5 percent, 10 percent, 15 percent, 20 percent, 25 percent, percent, 30 percent, 35 percent, 40 percent, 45 percent, 50 percent, 55 percent, 60 percent, 70 percent, 80 percent, 90 percent or 100 percent.

[0016] The fucan composition can be a fucan-low endotoxin composition comprising less than about 0.2 endotoxin units per milligram of the fucan. The fucan composition can be a high-molecular-weight fucan wherein the high-molecular-weight fucan has a molecular weight distribution wherein at least about 92% w / w of the molecular weight distribution of the fucan can be greater than 100 kDa when measured using an aqueous gel permeation chromatography set up consisting of: one 300 mm analytical gel permeation chromatography column with a 7.8 mm inner diameter packed with hydroxylated polymethacrylate-based gel, having an effective molecular weight range of between about 50 kDa and about 5,000 kDa, one 300 mm analytical gel permeation chromatography column with a 7.8 mm inner diameter packed with hydroxylated polymethacrylate-based gel, having an effective molecular weight range of between about 1 kDa and about 6,000 kDa and one 40 mm guard column with a 6 mm inner diameter packed with hydroxylated polymethacrylate-based gel, the two analytical gel permeation chromatography columns and the one guard column contained in a column compartment at about 30 °C; a refractive index detector at about 30 °C;a 0. IM sodium nitrate mobile phase run at 0.6 mL / min; and quantification against a peak molecular weight standard curve consisting of a first dextran standard with a peak molecular weight of about 2,200 kDa, a second dextran standard with a peak molecular weight of between about 720 kDa and about 760 kDa, a third dextran standard with a peak molecular weight between about 470 kDa and about 510 kDa, a fourth dextran standard with a peak molecular weight between about 370 kDa and about 410 kDa, a fifth dextran standard with a peak molecular weight between about 180 kDa and about 220 kDa, and a sixth dextran standard with a peak molecular weight between about 40 kDa and 55 kDa.The fucan composition can be a medically acceptable high-sulfate fucan having a sulfate content of between 20% w / w and 55% w / w.

[0017] Further aspects herein include systems comprise a vial, arthroscope, needle or needle and syringe containing a therapeutically effective dose of a selected medically acceptable fucan composition, the dose selected for and sufficient to increase range of motion, or inhibit or prevent decrease, in an articulating joint having, suspected of having or anticipated to have a limited range of motion. The systems further can comprise labelling or instructions for use of the system to be administered to an articulating joint having a limited range of motion in order to increase the range of motion articulating joint.

[0018] The fucan comprise a purified and modified fucan polymeric structure and counterions, wherein the purified and modified fucan polymeric structure consists essentially of fucose, galactose and sulfate, and wherein the purified and modified fucan comprise no more than about 17% counterions, and wherein a total content of fucose, galactose, sulfate and counterions of the purified and modified fucan can be greater than 97% w / w.

[0019] Fucan composition is in a medically acceptable formulation and the medically acceptable formulation further comprises can comprise at least one diluent, carrier or lubricant specific to delivery of the medically acceptable fucan composition to an articulating joint. The articulating joint can be a multiaxial articulating joint or a monoaxial articulating joint.

[0020] The methods further can comprise administering the dose via an arthroscope, a syringe or a syringe and needle. The dose can be in contact with an articulating joint or can be inserted into an articulating joint. The articulating joint can be a knee, shoulder, hip, intervertebral disc, synovial joint, hinge joint, pivot synovial joint, condyloid joint, pivot joint, ball and socket joint,elbow joint, ankle joint, or finger joint. The articulating joint can comprise a tendon, ligament or bursa. The selected therapeutically effective dose of the medically acceptable fucan composition can be administered to the articulating joint via an arthroscope, and before, during or after an arthroscopic procedure. The selected therapeutically effective dose of the medically acceptable fucan composition can be administered to the articulating joint before, during or after an arthroplasty. The selected therapeutically effective dose of the medically acceptable fucan composition can be administered to the articulating joint before, during or after manipulation of the articulating joint with or without anesthesia.

[0021] The therapeutically effective dose can comprise 2.5 mg, 5 mg, 10 mg, 15 mg, 20 mg, 25 mg, 30 mg, 50 mg, 60 mg, 70 mg, 80 mg, 90 mg, 100 mg, 150 mg, 200 mg, or 250 mg of the medically acceptable fucan. The therapeutically effective dose can comprise 1 mL, 2 mL, 3 mL, 4 mL, 5 mL, 10 mL, 15 mL, 20 mL, 25 mL, or 50 mL of solution containing the medically acceptable fucan.

[0022] The therapeutically effective dose further can comprise at least one diluent, carrier or lubricant specific to delivery of the medically acceptable fucan composition to an articulating joint, and wherein the dose can be located in a container having labelling or instructions for use of the dose to be administered to the articulating joint having the limited range of motion in order to increase the range of motion articulating joint.

[0023] The articulating joint can be an animal articulating joint and can be a human articulating joint.

[0024] These and other aspects, features and embodiments are set forth within this application, including the following Detailed Description and attached drawings. Unless expressly stated otherwise, all embodiments, aspects, features, etc., can be mixed and matched, combined and permuted in any desired manner. In addition, various references are set forth herein, including in the Cross-Reference To Related Applications, that discuss certain systems, apparatus, methods and other information; all such references are incorporated herein by reference in their entirety and for all their teachings and disclosures, regardless of where the references may appear in this application. Such references are not necessarily prior art to the current application.BRIEF DESCRIPTION OF THE DRAWINGS

[0025] Figure 1 depicts a stylized perspective view an arthroscopy of an articulating joint having a limited range of motion, comprising administering fucan compositions as discussed herein to the articulating joint to increase range of motion of the joint.DETAILED DESCRIPTION

[0026] The current methods, compositions, devices, systems, etc., discussed herein provide for increasing range of motion of an articulating joint having a limited range of motion. The methods can comprise:- identifying that the articulating joint has a limited range of motion,- selecting a selected therapeutically effective dose of a medically acceptable fucan composition sufficient to increase range of motion in the articulating joint,- administering to the articulating joint the selected therapeutically effective dose of the medically acceptable fucan composition, and- thereby increasing the range of motion of the articulating joint.

[0027] The current methods, compositions, devices, systems, etc., discussed herein comprise medically-acceptable fucan compositions and loads or dosages for increasing range of motion, including for restoring full range of motion, for preventing loss of range of motion and other purposes related to enhancing range of motion in an articulating joint. Fucans suitable for use herein are configured to be effective for treating reduced range of motion / increasing range of motion of one or more articulating joints in a subject including human subjects.

[0028] Reduced range of motion refers to a limitation in the normal movement of a joint, or where the joint exhibits limited mobility, or where the joint is incapable of achieving its normal anatomical limits of motion, either actively or passively. This means the joint cannot move as far or as freely as it should, either in a specific direction or in multiple directions. Reduced range of motion can affect one or more joints and may interfere with daily activities such as walking, reaching, or bending.

[0029] Figure 1 depicts a stylized perspective view an arthroscopy of an articulating joint having a limited range of motion or which is anticipated to have limited range of motion in the future including future concerns due to a specific identified cause such as surgery or arthritis. In Fig. 1, an arthroscope 2 is inserted into the articulating joint 4 which has fibrous connective tissue 6, e.g.,a ligament, tendon or bursa depending for example on location within the joint or connecting to the joint. The methods herein comprise administering fucan compositions as discussed herein through the arthroscope 2 to the articulating joint 4 to thereby increase range of motion of the joint. The arthroscope 2 and / or fucan solution 8 located within the arthroscope can have thereon or associated therewith instructions for implementing the methods, etc., herein.

[0030] Suitable medically-acceptable fucan configurations can include a paste, gel, patch, film, spray, liquid, lotion, cream, solution, suspension, solid, implant, microsphere, powder or other desired form. In some embodiments, the configuration can essentially comprise the medically- acceptable fucan. Improving the range of motion in a joint can comprise administering the medically-acceptable fucan to the joint. In other embodiments, the medically-acceptable fucan can be administered to the articulating joint prior to, contemporaneously with, or after conducting other range of motion treatments such as manipulation under anesthesia or manipulation without anesthesia. Such administration can occur in vivo during, before and / or after a medical, surgical or other procedure involving the joint. Suitable modes of administration can include intraarticular, periarticular, topical application and direct application to a surgical site.

[0031] In some embodiments, the medically-acceptable fucan is fucoidan. The present medically-acceptable fucans can themselves be, or can be included on or in, medical devices, combination products, biologies or in pharmaceutically or medically-acceptable, therapeutically and / or medically effective compositions. The compositions discussed herein can comprise medically-acceptable modified fucans with a desired, specific low endotoxin level for use in a treatment, medical and / or surgical setting. The compositions herein may further comprise medically-acceptable modified fucans having a desired, specific molecular weight distribution and / or sulfate level.

[0032] Exemplary reasons and conditions that can cause limited range of motion in a joint can include, for example, inflammation and swelling, capsular tightness or contracture, muscle and tendon tightness, injury or trauma such as ligament / tendon / muscle strains, radiation, infection, and joint fractures, surgical scar tissue formation, joint degradation, immobilization, joint malalignment and other structural abnormalities.

[0033] The medically acceptable fucans discussed herein can be used to improve the range of motion in patients having reduced range of motion due to, for example, the reasons discussed herein, including increased range of motion after surgery to increase range of motion compared to range of motion increases or decreases after such surgeries without administration of themedically-acceptable fucan. Medically acceptable fucans can be administered to such joints suffering from or suspected of suffering from limited range of motion. Medically applicable fucans can be administered to such joints anticipated to suffer from limited range of motion in the future due to a specific identified cause, including causes anticipated to induce the loss of range of motion within the following 1, 2, 3, 4 or 8 weeks, such as surgeries, injuries, arthritis, and infections. Medically acceptable fucans can be administered to target structures within joints (e.g., ligaments, tendons, bursae, muscles, capsules, nerves and blood vessels). Such administration can occur in the course of treating an exhibited or anticipated limited range of motion, for example, surgery, manipulation under anesthesia or manipulation without anesthesia to improve range of motion in a joint, wherein the medically acceptable fucan is administered to the surgical or manipulation site (i.e., thejoint) ortarget structures within the surgical or manipulation site (e.g., ligaments, tendons, bursae, muscles, capsules, nerves and blood vessels) before or after closing the surgical cavity during a surgery and before, during or after a manipulation. Surgery discussed herein includes, for example, arthroscopy, arthroplasty, arthrocentesis, osteotomy, capsular release, ligament reconstruction, cartilage repair, synovectomy, tendon or muscle transplant or transfer and joint debridement.Fucans

[0034] The medically-acceptable fucan compositions discussed herein may be modified to obtain medically-acceptable modified fucan compositions having low endotoxin levels. The medically-acceptable modified fucan compositions discussed herein may have an endotoxin level of less than about 0.2, 0.18, 0.12, 0.1, 0.09, 0.02, 0.01, 0.007, 0.005, 0.002 or 0.001 endotoxin units (EU) per milligram (mg) of the fucan (EU / mg).

[0035] The medically-acceptable fucans discussed herein may be modified to obtain medically- acceptable modified fucans having low total nitrogen levels by removing nitrogen containing compounds that may be attached to the medically-acceptable fucan. The medically-acceptable modified fucans, and compositions comprising the medically-acceptable modified fucans discussed herein may have a total nitrogen level of less than 0.2, 0.1, 0.08, 0.05, 0.03 or 0.02 % w / w.

[0036] The medically-acceptable fucans and medically-acceptable modified fucans discussed herein may be incorporated in compositions further comprising any number of medically and pharmaceutically acceptable excipients, for example, gelatin, hypromellose, lactose, water for injectionUSP, sodium chloride, sodium phosphate, sodium citrate, sodium ascorbate, phosphate buffers, citrate buffers, phosphate-citrate buffers, pluronic, cellulose, alginate, acrylate, hyaluronic acid, polyethylene glycol, lactic acid, carrageenan, polyurethane, polyethylene, polypropylene, polytetrafluoroethylene, chitosan, injectable excipients, normal saline and Lactated Ringer’s Injection USP.

[0037] The medically-acceptable fucans and medically-acceptable modified fucans discussed herein may be provided in a composition comprising at least one of a paste, gel, patch, film, spray, liquid, lotion, cream, solution, suspension, solid, implant, microsphere, powder or other desired form. For in vivo use, medically-acceptable fucans and medically-acceptable modified fucans may be administered via intraarticular, periarticular or topical routes. The medically-acceptable fucans and medically-acceptable modified fucans may be directly delivered to the site where improved range of motion is required or suspected to be required. The medically-acceptable fucans and medically-acceptable modified fucans may be continuously released to the site of where improved range of motion is required or suspected to be required via controlled release from a polymeric or other acceptable controlled release dosage form. A solution or spray comprising the medically- acceptable fucans and / or medically-acceptable modified fucans herein may be used to irrigate, rinse, flush or wash the site where the improved range of motion is required or suspected to be required. The site where the improved range of motion is required or suspected to be required may be the site of at least one of a fibrous, cartilaginous or synovial joint.

[0038] The medically-acceptable fucans and medically-acceptable modified fucans discussed herein may be administered as a component of a medical device or an active pharmaceutical ingredient (API) or combination product or medical composition comprising the medically-acceptable fucan / medically-acceptable modified fucan and at least one API that is not a fucan. The API may be at least one of analgesic, antipyretic, antibiotic, antidepressant, antihypertensive, antidiabetic agent, anti-inflammatory drug, anticoagulant, antipsychotic, antiviral agent, hormone, immunosuppressant, biologic, protein, antibody, vaccine, and cellular therapy agent.

[0039] The medically-acceptable fucans and medically-acceptable modified fucans discussed herein may be administered as a component of a medical device or an API or combination product or medical composition comprising the medically-acceptable fucan / medically-acceptable modified fucan and at least one binder, adjuvant, excipient, etc.

[0040] The medically-acceptable fucans and medically-acceptable modified fucans discussed herein may have a sulfation level of between about 10% w / w and 60% w / w, between about 20% w / w and 55% w / w, between about 30% w / w and 50% w / w, or between about 40% w / w and 45% w / w.

[0041] The medically-acceptable fucans and medically-acceptable modified fucans discussed herein may have a molar ratio of total fucose:total sulfate of between 1 :0.5 and 1 :4, between about 1 :0.8 and 1 :3.5, between about 1 : 1 and 1 :2.5, between about 1 : 1.2 and 1 :2.0, or between about 1 : 1.5 and 1 :3.

[0042] The medically-acceptable fucans and medically-acceptable modified fucans discussed herein may have a molar ratio of total fucose and galactose :total sulfate of between about 1 :0.5 and 1 :4, between about 1 :0.8 and 1 :3.5, between about 1 : 1 and 1 :2.5, between about 1 : 1.2 and 1 :2.0, or between about 1 : 1.5 and 1 :3.

[0043] The medically-acceptable fucans discussed herein may be modified to obtain medically- acceptable modified fucans having increased or decreased weight average molecular weight, number average molecular weight and / or peak molecular weight. The medically-acceptable fucans, having broad molecular weight distributions, discussed herein may be modified to obtain medically-acceptable modified fucans having a molecular weight distribution wherein a portion of the fucan at the low molecular weight end or at the high molecular weight end of the broad molecular weight distribution has been reduced or eliminated.

[0044] The molecular weight distribution of the medically-acceptable modified fucans may be measured using any desired, appropriate measurement system. Different systems can yield different readings or results from different compositions having essentially the same make-up, or even from the same batch when measured differently. One suitable measurement system is an aqueous gel permeation chromatography set up consisting essentially of one 300 mm analytical gel permeation chromatography column with a 7.8 mm inner diameter packed with hydroxylated polymethacrylate-based gel, having an effective molecular weight range of between about 50 kDa and about 5,000 kDa, one 300 mm analytical gel permeation chromatography column with a 7.8 mm inner diameter packed with hydroxylated polymethacrylate-based gel, having an effective molecular weight range of between about 1 kDa and about 6,000 kDa and one 40 mm guard column with a 6 mm inner diameter packed with hydroxylated polymethacrylate-based gel, the two analytical gel permeation chromatography columns and the one guard column contained in a columncompartment at about 30 °C, a refractive index detector at about 30 °C, 0. IM sodium nitrate mobile phase run at 0.6 mL / min, and quantification against a peak molecular weight standard curve consisting essentially of a first dextran standard with a peak molecular weight of about 2,200 kDa, a second dextran standard with a peak molecular weight of between about 720 kDa and about 760 kDa, a third dextran standard with a peak molecular weight between about 470 kDa and about 510 kDa, a fourth dextran standard with a peak molecular weight between about 370 kDa and about 410 kDa, a fifth dextran standard with a peak molecular weight between about 180 kDa and about 220 kDa, and a sixth dextran standard with a peak molecular weight between about 40 kDa and 55 kDa. The peak molecular weight standard curve may further comprise a dextran standard with a peak molecular weight between 3 kDa and 5 kDa.

[0045] The medically-acceptable modified fucans discussed herein may have a weight average molecular weight greater than 300 kDa, for example between about 300 kDa and 2000 kDa, between about 350 kDa and 1500 kDa or between about 375 kDa and 1300 kDa.

[0046] The medically-acceptable modified fucans discussed herein may have a number average molecular weight greater than 100 kDa, for example between about 100 kDa and 800 kDa, between about 150 kDa and about 800 kDa or between about 170 kDa and 700 kDa.

[0047] The medically-acceptable modified fucans discussed herein may have a peak molecular weight greater than 200 kDa, for example between about 200 kDa and 800 kDa, between about 250 kDa and 750 kDa or between about 300 kDa and 700 kDa.

[0048] The medically-acceptable modified fucans discussed herein can have a molecular weight distribution wherein at least about 80% w / w or 90% w / w of the distribution is above 100 kDa. The medically-acceptable modified fucans discussed herein can have a molecular weight distribution wherein at least about 60% w / w, 70% w / w, 80% w / w or 90% w / w of the distribution is above 200 kDa. The medically-acceptable modified fucans discussed herein can have a molecular weight distribution wherein at least 20%, 40%, 50% or 70% of the distribution is above 500 kDa.

[0049] The medically-acceptable fucans and medically-acceptable modified fucans discussed herein may have a total carbohydrate content of between 27% w / w and 80% w / w, between about 30% w / w and 70% w / w, between about 40% w / w and 90% w / w, or between about 50% w / w and 100% w / w.

[0050] The medically-acceptable fucans and medically-acceptable modified fucans discussed herein may have a fucose content as a percentage of total carbohydrate of about 30% w / w and 100% w / w, between about 40% w / w and 95% w / w, or between about 50% w / w and 90% w / w.

[0051] The medically-acceptable fucans and medically-acceptable modified fucans discussed herein may have a galactose content as a percentage of total carbohydrate of about 0% w / w and 60% w / w, between about 3% w / w and 30% w / w, or between about 0% w / w and 10% w / w.

[0052] The medically-acceptable fucans and medically-acceptable modified fucans discussed herein may have a total glucuronic acid, mannose, rhamnose and xylose content as a percentage of the total carbohydrate content of less than about 30% w / w.ExamplesExample 1: Treatment of limited range of motion in human knee

[0053] A patient sustained an ACL and MCL injury playing soccer on turf. After an initial period of 3 weeks of rehabilitation they were brought to the operating room for an anterior cruciate ligament (ACL) reconstruction and medial collateral ligament (MCL) repair. At 8 weeks post-op they had significant motion loss, having only 5° to 80° range of motion (ROM). They returned to the operating room for a manipulation under anesthesia (MU A) and additional rehabilitation. By 18 weeks after the first surgery, motion was still limited, at 3° to 95° range of motion. At this stage they underwent an arthroscopic lysis or release of adhesions (adhesiolysis), manipulation under anesthesia, and administration via arthroscopy of 10 mL of 5 mg / mL fucan in a medically acceptable buffered physiological solution (total load or dosage of 50 mg fucan) into the knee joint. The fucan was prepared according to the methods disclosed in PCT / CA2019 / 051025, PCT / CA2019 / 051026, PCT / CA2019 / 051027, PCT / CA2019 / 051030, PCT / CA2019 / 051028, PCT / CA2020 / 050294, PCT / CA2020 / 050295, and PCT / CA2019 / 051029 (cited previously in this application). No adverse events were observed after administration of the fucan to the patient.

[0054] Following this procedure and treatment, at approximately 6 weeks the patient had 0-135 range of motion and has subsequently regained full motion and returned to trail running and hiking.Baseline: 3 to 95 degrees range of motionPost re-operation + Fucan treatment: 0 to 135 degrees range of motion135 degrees - 95 degrees = 40 degrees improvement(135 degrees - 95 degrees) / 95 degrees = about 42% improvementExample 2: Treatment of limited range of motion in human knee

[0055] A patient presented with left knee pain. X-rays revealed advanced patella-femoral arthritis. They underwent a patella-femoral arthroplasty (replacement). They struggled to regain knee motion and at 12 weeks post-operation they had 10° to 90° range of motion with pain. A manipulation under anesthesia was performed, but range of motion was not maintained post procedure. 5 months later they returned to the operating room for a knee arthroscopy and lysis of adhesions with administration via arthroscopy of 10 mL of 5 mg / mL fucan in a medically acceptable buffered physiological solution (total load or dosage of 50 mg fucan) into the knee joint. The fucan was prepared according to the methods disclosed in PCT / CA2019 / 051025, PCT / CA2019 / 051026, PCT / CA2019 / 051027, PCT / CA2019 / 051030, PCT / CA2019 / 051028, PCT / CA2020 / 050294, PCT / CA2020 / 050295, and PCT / CA2019 / 051029 (cited previously in this application). No adverse events were observed after administration of the fucan to the patient.

[0056] 5 months later they had 0 to 115° range of motion and were heading for an active trip with lots of walking.Baseline: 10 to 90 degrees range of motionPost re-operation + Fucan treatment: 0 to 115 degrees range of motion115 degrees - 90 degrees = 25 degrees improvement(115 degrees - 90 degrees) / 90 degrees = about 28% improvementExample 3: Treatment of limited range of motion in human shoulder

[0057] 34-year-old patient with type 1 diabetes mellitus presented with bilateral adhesive capsulitis of the patient’s shoulders (“frozen shoulders”). The patient underwent a shoulder arthroscopy and capsular release to the patient’s left shoulder. At the end of the procedure an injection into the shoulder joint through the side-port of the arthroscope of 10 mL of 5 mg / mL fucan in a medically acceptable buffered physiological solution (total load or dosage of 50 mg fucan) was performed. The fucan was prepared according to the methods disclosed in PCT / CA2019 / 051025, PCT / CA2019 / 051026, PCT / CA2019 / 051027, PCT / CA2019 / 051030, PCT / CA2019 / 051028, PCT / CA2020 / 050294, PCT / CA2020 / 050295, and PCT / CA2019 / 051029 (cited previously in this application). No adverse events were observed after administration of the fucan to the patient. Following the procedure the patient regained excellent motion.

[0058] Approximately 5 months after the left shoulder operation plus fucan treatment, the patient's right shoulder underwent a similar arthroscopic release without use of any fucan. Approximately 2 months after the right shoulder operation without use of fucan, the patient had the following:

[0059] Left shoulder (with fucan treatment):Baseline: Forward elevation: 110 degrees range of motion; External rotation: 0 degrees range of motion.Post-op + fucan at approximately 7 months: Forward elevation: 160 degrees range of motion; External rotation: 45 degrees range of motionForward elevation: 160 degrees - 110 degrees = 50 degrees improvement in range of motion compared with baseline(160 degrees - 110 degrees) / l 10 degrees = about 45% improvement compared with baselineExternal rotation: 45 degrees - 0 degrees = 45 degrees improvement in range of motion compared with baselineThe increase from 0 degrees to 45 degrees for external rotation cannot be expressed mathematically as a percentage, yet is clearly a strikingly positive improvement compared with baselineRight shoulder (no fucan treatment):Baseline: Forward Elevation: 110 degrees range of motion; External Rotation: 0 degrees range of motion (same as left shoulder).Post-op at approximately 2 months: Forward Elevation: 125 degrees range of motion;External Rotation: 22 degrees range of motionForward elevation: 125 degrees - 110 degrees = 15 degrees improvement in range of motion compared with baseline(125 degrees - 110 degrees) / l 10 degrees = about 14% improvement compared with baselineExternal rotation: 22 degrees - 0 degrees = 22 degrees improvement in range of motion compared with baselineThe increase from 0 degrees to 22 degrees or external rotation cannot be expressed mathematically as a percentage

[0060] Comparing the fucan treatment shoulder to the no fucan treatment shoulder for forward elevation shows a 50 degree increase for the fucan treatment compared to only a 15 degree increase without the fucan treatment, or about a 35 degree greater increase with fucan treatment compared with no fucan treatment. This can also be expressed as an about 233% relative greater improvement with fucan treatment compared with no fucan treatment ((50 degree improvement with fucan treatment - 15 degree improvement without fucan treatment) / 15 degree improvement without fucan treatment = about a 233% relative greater improvement).

[0061] Comparing the fucan treatment shoulder to the no fucan treatment shoulder for external rotation shows a 45 degree increase for the fucan treatment compared to only a 22 degree increase without the fucan treatment, or about a 23 degree greater increase with fucan treatment compared with no fucan treatment. This can also be expressed as an about 105% relative greater improvement with fucan treatment compared to no fucan treatment (45 degree improvement with fucan treatment - 22 degree improvement without fucan treatment) / 22 degree improvement without fucan treatment = about a 105% relative greater improvement with fucan).

[0062] All terms used herein are used in accordance with their ordinary meanings unless the context or definition clearly indicates otherwise. Also unless expressly indicated otherwise, in this disclosure the use of "or" includes "and" and vice-versa. Non-limiting terms are not to be construed as limiting unless expressly stated, or the context clearly indicates, otherwise (for example, "including," "having," and "comprising" typically indicate "including without limitation"). Singular forms, including in the claims, such as "a," "an," and "the" include the plural reference unless expressly stated, or the context clearly indicates otherwise.

[0063] Unless otherwise stated, adjectives herein such as “substantially” and “about” that modify a condition or relationship characteristic of a feature or features of an embodiment, indicate that the condition or characteristic is defined to within tolerances that are acceptable for operation of the embodiment for an application for which it is intended.

[0064] The scope of the present methods, compositions, systems, etc., includes both means plus function and step plus function concepts. However, the claims are not to be interpreted as indicating a "means plus function" relationship unless the word "means" is specifically recited in a claim, and are to be interpreted as indicating a "means plus function" relationship where the word "means"is specifically recited in a claim. Similarly, the claims are not to be interpreted as indicating a "step plus function" relationship unless the word "step" is specifically recited in a claim, and are to be interpreted as indicating a "step plus function" relationship where the word "step" is specifically recited in a claim.

[0065] From the foregoing, it will be appreciated that, although specific embodiments have been discussed herein for purposes of illustration, various modifications may be made without deviating from the spirit and scope of the discussion herein. Accordingly, the systems and methods, etc., include such modifications as well as all permutations and combinations of the subject matter set forth herein and are not limited except as by the appended claims or other claim 1 having adequate support in the discussion and figures herein.

Claims

What is claimed is:

1. A method of increasing range of motion of an articulating joint having a limited range of motion, the method comprising:- identifying that the articulating joint has a limited range of motion,- selecting a therapeutically effective dose of a medically acceptable fucan composition to provide a selected therapeutically effective dose of a medically acceptable fucan sufficient to increase range of motion in the articulating joint,- administering to the articulating joint the selected therapeutically effective dose of the medically acceptable fucan composition in order to increase the range of motion of the articulating joint.

2. The method of claim 1 wherein the therapeutically effective dose of the selected medically acceptable fucan is sufficient to significantly increase range of motion in the articulating joint.

3. A method of increasing range of motion of an articulating j oint suspected of having a limited range of motion, the method comprising:- identifying that the articulating joint has a suspected limited range of motion,- selecting a therapeutically effective dose of a medically acceptable fucan composition to provide a selected therapeutically effective dose of a medically acceptable fucan sufficient to increase range of motion in the articulating joint,- administering to the articulating joint the selected therapeutically effective dose of the medically acceptable fucan composition in order to increase the range of motion of the articulating joint.

4. The method of claim 3 wherein the therapeutically effective dose of the selected medically acceptable fucan is sufficient to significantly increase range of motion in the articulating joint.

5. The method of any one of claims 1 to 4 wherein the therapeutically effective dose of the selected medically acceptable fucan is sufficient to increase range of motion in the articulating joint by at least 10 degrees and wherein the method increases the range of motion in the articulating joint by at least 10 degrees.

6. The method of any one of claims 1 to 4 wherein the therapeutically effective dose of the selected medically acceptable fucan is sufficient to increase range of motion in the articulating joint by at least 15 degrees and wherein the method increases the range of motion in the articulating joint by at least 15 degrees.

7. The method of any one of claims 1 to 4 wherein the therapeutically effective dose of the selected medically acceptable fucan is sufficient to increase range of motion in the articulating joint by at least 20 degrees and wherein the method increases the range of motion in the articulating joint by at least 20 degrees.

8. The method of any one of claims 1 to 4 wherein the therapeutically effective dose of the selected medically acceptable fucan is sufficient to increase range of motion in the articulating joint by at least 25 degrees and wherein the method increases the range of motion in the articulating joint by at least 25 degrees.

9. The method of any one of claims 1 to 4 wherein the therapeutically effective dose of the selected medically acceptable fucan is sufficient to increase range of motion in the articulating joint by at least 30 degrees and wherein the method increases the range of motion in the articulating joint by at least 30 degrees.

10. The method of any one of claims 1 to 4 wherein the therapeutically effective dose of the selected medically acceptable fucan is sufficient to increase range of motion in the articulating joint by at least 35 degrees and wherein the method increases the range of motion in the articulating joint by at least 35 degrees.

11. The method of any one of claims 1 to 4 wherein the therapeutically effective dose of the selected medically acceptable fucan is sufficient to increase range of motion in the articulating joint by at least 40 degrees and wherein the method increases the range of motion in the articulating joint by at least 40 degrees.

12. The method of any one of claims 1 to 4 wherein the therapeutically effective dose of the selected medically acceptable fucan is sufficient to increase range of motion in the articulating joint by at least 45 degrees and wherein the method increases the range of motion in the articulating joint by at least 45 degrees.

13. The method of any one of claims 1 to 4 wherein the therapeutically effective dose of the selected medically acceptable fucan is sufficient to increase range of motion in thearticulating joint by at least 50 degrees and wherein the method increases the range of motion in the articulating joint by at least 50 degrees.

14. The method of any one of claims 1 to 4 wherein the therapeutically effective dose of the selected medically acceptable fucan is sufficient to increase range of motion in the articulating joint by at least 60 degrees and wherein the method increases the range of motion in the articulating joint by at least 60 degrees.

15. The method of any one of claims 1 to 4 wherein the therapeutically effective dose of the selected medically acceptable fucan is sufficient to increase range of motion in the articulating joint by at least 70 degrees and wherein the method increases the range of motion in the articulating joint by at least 70 degrees.

16. The method of any one of claims 1 to 4 wherein the therapeutically effective dose of the selected medically acceptable fucan is sufficient to increase range of motion in the articulating joint by at least 80 degrees and wherein the method increases the range of motion in the articulating joint by at least 80 degrees.

17. The method of any one of claims 1 to 4 wherein the therapeutically effective dose of the selected medically acceptable fucan is sufficient to increase range of motion in the articulating joint by at least 90 degrees and wherein the method increases the range of motion in the articulating joint by at least 90 degrees.

18. The method of any one of claims 1 to 4 wherein the therapeutically effective dose of the selected medically acceptable fucan is sufficient to increase range of motion in the articulating joint by at least 5% and wherein the method increases the range of motion in the articulating joint by at least 5%.

19. The method of any one of claims 1 to 4 wherein the therapeutically effective dose of the selected medically acceptable fucan is sufficient to increase range of motion in the articulating joint by at least 10% and wherein the method increases the range of motion in the articulating joint by at least 10%.

20. The method of any one of claims 1 to 4 wherein the therapeutically effective dose of the selected medically acceptable fucan is sufficient to increase range of motion in the articulating joint by at least 15% and wherein the method increases the range of motion in the articulating joint by at least 15%.

21. The method of any one of claims 1 to 4 wherein the therapeutically effective dose of the selected medically acceptable fucan is sufficient to increase range of motion in the articulating joint by at least 20% and wherein the method increases the range of motion in the articulating joint by at least 20%.

22. The method of any one of claims 1 to 4 wherein the therapeutically effective dose of the selected medically acceptable fucan is sufficient to increase range of motion in the articulating joint by at least 25% and wherein the method increases the range of motion in the articulating joint by at least 25%.

23. The method of any one of claims 1 to 4 wherein the therapeutically effective dose of the selected medically acceptable fucan is sufficient to increase range of motion in the articulating joint by at least 28% and wherein the method increases the range of motion in the articulating joint by at least 28%.

24. The method of any one of claims 1 to 4 wherein the therapeutically effective dose of the selected medically acceptable fucan is sufficient to increase range of motion in the articulating joint by at least 30% and wherein the method increases the range of motion in the articulating joint by at least 30%.

25. The method of any one of claims 1 to 4 wherein the therapeutically effective dose of the selected medically acceptable fucan is sufficient to increase range of motion in the articulating joint by at least 35% and wherein the method increases the range of motion in the articulating joint by at least 35%.

26. The method of any one of claims 1 to 4 wherein the therapeutically effective dose of the selected medically acceptable fucan is sufficient to increase range of motion in the articulating joint by at least 40% and wherein the method increases the range of motion in the articulating joint by at least 40%.

27. The method of any one of claims 1 to 4 wherein the therapeutically effective dose of the selected medically acceptable fucan is sufficient to increase range of motion in the articulating joint by at least 42% and wherein the method increases the range of motion in the articulating joint by at least 42%.

28. The method of any one of claims 1 to 4 wherein the therapeutically effective dose of the selected medically acceptable fucan is sufficient to increase range of motion in thearticulating joint by at least 45% and wherein the method increases the range of motion in the articulating joint by at least 45%.

29. The method of any one of claims 1 to 4 wherein the therapeutically effective dose of the selected medically acceptable fucan is sufficient to increase range of motion in the articulating joint by at least 50% and wherein the method increases the range of motion in the articulating joint by at least 50%.

30. The method of any one of claims 1 to 4 wherein the therapeutically effective dose of the selected medically acceptable fucan is sufficient to increase range of motion in the articulating joint by at least 60% and wherein the method increases the range of motion in the articulating joint by at least 60%.

31. The method of any one of claims 1 to 4 wherein the therapeutically effective dose of the selected medically acceptable fucan is sufficient to increase range of motion in the articulating joint by at least 70% and wherein the method increases the range of motion in the articulating joint by at least 70%.

32. The method of any one of claims 1 to 4 wherein the therapeutically effective dose of the selected medically acceptable fucan is sufficient to increase range of motion in the articulating joint by at least 80% and wherein the method increases the range of motion in the articulating joint by at least 80%.

33. The method of any one of claims 1 to 4 wherein the therapeutically effective dose of the selected medically acceptable fucan is sufficient to increase range of motion in the articulating joint by at least 90% and wherein the method increases the range of motion in the articulating joint by at least 90%.

34. The method of any one of claims 1 to 4 wherein the therapeutically effective dose of the selected medically acceptable fucan is sufficient to increase range of motion in the articulating joint by at least 100% and wherein the method increases the range of motion in the articulating joint by at least 100%.

35. The method of any one of claims 1 to 34 wherein the fucan composition is a fucan-low endotoxin composition comprising less than about 0.2 endotoxin units per milligram of the fucan.

36. The method of any one of claims 1 to 35 wherein the fucan composition is a high-molecular-weight fucan wherein the high-molecular-weight fucan has a molecular weightdistribution wherein at least about 92% w / w of the molecular weight distribution of the fucan is greater than 100 kDa when measured using an aqueous gel permeation chromatography set up consisting of: one 300 mm analytical gel permeation chromatography column with a 7.8 mm inner diameter packed with hydroxylated polymethacrylate-based gel, having an effective molecular weight range of between about 50 kDa and about 5,000 kDa, one 300 mm analytical gel permeation chromatography column with a 7.8 mm inner diameter packed with hydroxylated polymethacrylate-based gel, having an effective molecular weight range of between about 1 kDa and about 6,000 kDa and one 40 mm guard column with a 6 mm inner diameter packed with hydroxylated polymethacrylate-based gel, the two analytical gel permeation chromatography columns and the one guard column contained in a column compartment at about 30 °C; a refractive index detector at about 30 °C; a 0. IM sodium nitrate mobile phase run at 0.6 mL / min; and quantification against a peak molecular weight standard curve consisting of a first dextran standard with a peak molecular weight of about 2,200 kDa, a second dextran standard with a peak molecular weight of between about 720 kDa and about 760 kDa, a third dextran standard with a peak molecular weight between about 470 kDa and about 510 kDa, a fourth dextran standard with a peak molecular weight between about 370 kDa and about 410 kDa, a fifth dextran standard with a peak molecular weight between about 180 kDa and about 220 kDa, and a sixth dextran standard with a peak molecular weight between about 40 kDa and 55 kDa.

37. The method of any one of claims 1 to 36 wherein the fucan composition is a medically acceptable high-sulfate fucan having a sulfate content of between 20% w / w and 55% w / w.

38. The method of any one of claims 1 to 37 wherein the fucan comprises a purified and modified fucan polymeric structure and counterions, wherein the purified and modified fucan polymeric structure consists essentially of fucose, galactose and sulfate, and wherein the purified and modified fucan comprises no more than about 17% counterions, and wherein a total content of fucose, galactose, sulfate and counterions of the purified and modified fucan is greater than 97% w / w.

39. The method of any one of claims 1 to 38 wherein the fucan composition is in a medically acceptable formulation dose and the medically acceptable formulation further comprises at least one diluent, carrier or lubricant specific to delivery of the medically acceptable fucan composition to an articulating joint.

40. The method of any one of claims 1 to claim 39 wherein the articulating joint is a multiax- ial articulating joint.

41. The method of any one of claims 1 to 40 wherein the articulating joint is a monoaxial articulating joint.

42. The method of any one of claims 1 to 41 wherein the method further comprises administering the dose via an arthroscope.

43. The method of any one of claims 1 to 41 wherein the method further comprises administering the dose via a syringe.

44. The method of any one of claims 1 to 41 wherein the method further comprises administering the dose via a syringe and needle.

45. The method of any one of claims 1 to 44 wherein the dose is in contact with an articulating joint.

46. The method of any one of claims 1 to 44 wherein the dose is inserted into an articulating joint.

47. The method of any one of claims 1 to 46 wherein the articulating joint is a knee.

48. The method of any one of claims 1 to 46 wherein the articulating joint is a shoulder.

49. The method of any one of claims 1 to 46 wherein the articulating joint is a hip.

50. The method of any one of claims 1 to 46 wherein the articulating joint is an intervertebral disc.

51. The method of any one of claims 1 to 46 wherein the articulating joint is a synovial joint.

52. The method of any one of claims 1 to 46 wherein the articulating joint is a hinge joint.

53. The method of any one of claims 1 to 46 wherein the articulating joint is a pivot joint.

54. The method of any one of claims 1 to 46 wherein the articulating joint is a condyloid joint.

55. The method of any one of claims 1 to 46 wherein the articulating joint is a ball and socket joint.

56. The method of any one of claims 1 to 46 wherein the articulating joint is an elbow joint.

57. The method of any one of claims 1 to 46 wherein the articulating joint is an ankle joint.

58. The method of any one of claims 1 to 46 wherein the articulating joint is a finger joint.

59. The method of any one of claims 1 to 46 wherein the articulating joint comprises a ligament.

60. The method of any one of claims 1 to 46 wherein the articulating joint comprises a tendon.

61. The method of any one of claims 1 to 60 wherein the selected therapeutically effective dose of the medically acceptable fucan composition is administered to the articulating joint via an arthroscope.

62. The method of any one of claims 1 to 60 wherein the selected therapeutically effective dose of the medically acceptable fucan composition is administered to the articulating joint during an arthroscopic procedure.

63. The method of any one of claims 1 to 60 wherein the selected therapeutically effective dose of the medically acceptable fucan composition is administered to the articulating joint after an arthroscopic procedure.

64. The method of any one of claims 1 to 60 wherein the selected therapeutically effective dose of the medically acceptable fucan composition is administered to the articulating joint during an arthroplasty.

65. The method of any one of claims 1 to 60 wherein the selected therapeutically effective dose of the medically acceptable fucan composition is administered to the articulating joint after an arthroplasty.

66. The method of any one of claims 1 to 65 wherein the selected therapeutically effective dose of the medically acceptable fucan composition is administered to the articulating joint during manipulation of the articulating joint with anesthesia.

67. The method of any one of claims 1 to 66 wherein the selected therapeutically effective dose of the medically acceptable fucan composition is administered to the articulating joint after manipulation of the articulating joint without anesthesia.

68. The method of any one of claims 1 to 67 wherein the therapeutically effective dose is in a medically acceptable formulation and the comprises 2.5 mg of the medically acceptable fucan.

69. The method of any one of claims 1 to 67 wherein the therapeutically effective dose is in a medically acceptable formulation and the comprises 5 mg of the medically acceptable fucan.

70. The method of any one of claims 1 to 67 wherein the therapeutically effective dose is in a medically acceptable formulation and the comprises 10 mg of the medically acceptable fucan.

71. The method of any one of claims 1 to 67 wherein the therapeutically effective dose is in a medically acceptable formulation and the comprises 15 mg of the medically acceptable fucan.

72. The method of any one of claims 1 to 67 wherein the therapeutically effective dose is in a medically acceptable formulation and the comprises 20 mg of the medically acceptable fucan.

73. The method of any one of claims 1 to 67 wherein the therapeutically effective dose is in a medically acceptable formulation and the comprises 25 mg of the medically acceptable fucan.

74. The method of any one of claims 1 to 67 wherein the therapeutically effective dose is in a medically acceptable formulation and the comprises 50 mg of the medically acceptable fucan.

75. The method of any one of claims 1 to 67 wherein the therapeutically effective dose is in a medically acceptable formulation and the comprises 100 mg of the medically acceptable fucan.

76. The method of any one of claims 1 to 67 wherein the therapeutically effective dose is in a medically acceptable formulation and the comprises 150 mg of the medically acceptable fucan.

77. The method of any one of claims 1 to 67 wherein the therapeutically effective dose is in a medically acceptable formulation and the comprises 200 mg of the medically acceptable fucan.

78. The method of any one of claims 1 to 67 wherein the therapeutically effective dose is in a medically acceptable formulation and the comprises 250 mg of the medically acceptable fucan.

79. The method of any one of claims 1 to 67 wherein the therapeutically effective dose is in a medically acceptable formulation and the medically acceptable formulation is in 1 mL of solution containing the medically acceptable fucan.

80. The method of any one of claims 1 to 67 wherein the therapeutically effective dose is in a medically acceptable formulation and the medically acceptable formulation is in 2 mL of solution containing the medically acceptable fucan.

81. The method of any one of claims 1 to 67 wherein the therapeutically effective dose is in a medically acceptable formulation and the medically acceptable formulation is in 3 mL of solution containing the medically acceptable fucan.

82. The method of any one of claims 1 to 67 wherein the therapeutically effective dose is in a medically acceptable formulation and the medically acceptable formulation is in 4 mL of solution containing the medically acceptable fucan.

83. The method of any one of claims 1 to 67 wherein the therapeutically effective dose is in a medically acceptable formulation and the medically acceptable formulation is in 5 mL of solution containing the medically acceptable fucan.

84. The method of any one of claims 1 to 67 wherein the therapeutically effective dose is in a medically acceptable formulation and the medically acceptable formulation is in 10 mL of solution containing the medically acceptable fucan.

85. The method of any one of claims 1 to 67 wherein the therapeutically effective dose is in a medically acceptable formulation and the medically acceptable formulation is in 15 mL of solution containing the medically acceptable fucan.

86. The method of any one of claims 1 to 67 wherein the therapeutically effective dose is in a medically acceptable formulation and the medically acceptable formulation is in 25 mL of solution containing the medically acceptable fucan.

87. The method of any one of claims 1 to 67 wherein the therapeutically effective dose is in a medically acceptable formulation and the medically acceptable formulation is in 50 mL of solution containing the medically acceptable fucan.

88. The method of any one of claims 1 to 87 wherein the articulating joint is an animal articulating joint.

89. The method of any one of claims 1 to 87 wherein the articulating joint is a human articulating joint.

90. A medically acceptable fucan for use as a medicament in the treatment of reduced range of motion in an articulating joint.

91. A medically acceptable fucan for use as a medicament in the treatment of inhibition of range of motion in an articulating joint.

92. A medically acceptable fucan for use as a medicament in the treatment of prevention of range of motion in an articulating joint.

93. A method of treating reduced range of motion in an animal comprising administering a therapeutically effective amount of a fucan to a site on or in an articulating joint having a reduced range of motion prior to the administering.

94. The method of claim 93 wherein the therapeutically effective dose of the selected medically acceptable fucan is sufficient to increase range of motion in the articulating joint by at least 5% and wherein the method increases the range of motion in the articulating joint by at least 5%.

95. The method of claim 93 wherein the therapeutically effective dose of the selected medically acceptable fucan is sufficient to increase range of motion in the articulating joint by at least 10% and wherein the method increases the range of motion in the articulating joint by at least 10%.

96. The method of claim 93 wherein the therapeutically effective dose of the selected medically acceptable fucan is sufficient to increase range of motion in the articulating joint by at least 15% and wherein the method increases the range of motion in the articulating joint by at least 15%.

97. The method of claim 93 wherein the therapeutically effective dose of the selected medically acceptable fucan is sufficient to increase range of motion in the articulating joint by at least 20% and wherein the method increases the range of motion in the articulating joint by at least 20%.

98. The method of claim 93 wherein the therapeutically effective dose of the selected medically acceptable fucan is sufficient to increase range of motion in the articulating joint by at least 25% and wherein the method increases the range of motion in the articulating joint by at least 25%.

99. The method of claim 93 wherein the therapeutically effective dose of the selected medically acceptable fucan is sufficient to increase range of motion in the articulating joint by at least 28% and wherein the method increases the range of motion in the articulating joint by at least 28%.

100. The method of claim 93 wherein the therapeutically effective dose of the selected medically acceptable fucan is sufficient to increase range of motion in the articulating joint by at least 30% and wherein the method increases the range of motion in the articulating joint by at least 30%.

101. The method of claim 93 wherein the therapeutically effective dose of the selected medically acceptable fucan is sufficient to increase range of motion in the articulating joint by at least 35% and wherein the method increases the range of motion in the articulating joint by at least 35%.

102. The method of claim 93 wherein the therapeutically effective dose of the selected medically acceptable fucan is sufficient to increase range of motion in the articulating joint by at least 40% and wherein the method increases the range of motion in the articulating joint by at least 40%.

103. The method of claim 93 wherein the therapeutically effective dose of the selected medically acceptable fucan is sufficient to increase range of motion in the articulating joint by at least 42% and wherein the method increases the range of motion in the articulating joint by at least 42%.

104. The method of claim 93 wherein the therapeutically effective dose of the selected medically acceptable fucan is sufficient to increase range of motion in the articulating joint by at least 45% and wherein the method increases the range of motion in the articulating joint by at least 45%.

105. The method of claim 93 wherein the therapeutically effective dose of the selected medically acceptable fucan is sufficient to increase range of motion in the articulating joint by at least 50% and wherein the method increases the range of motion in the articulating joint by at least 50%.

106. The method of claim 93 wherein the therapeutically effective dose of the selected medically acceptable fucan is sufficient to increase range of motion in the articulating joint by at least 60% and wherein the method increases the range of motion in the articulating joint by at least 60%.

107. The method of claim 93 wherein the therapeutically effective dose of the selected medically acceptable fucan is sufficient to increase range of motion in the articulating joint by at least70% and wherein the method increases the range of motion in the articulating joint by at least 70%.

108. The method of claim 93 wherein the therapeutically effective dose of the selected medically acceptable fucan is sufficient to increase range of motion in the articulating joint by at least 80% and wherein the method increases the range of motion in the articulating joint by at least 80%.

109. The method of claim 93 wherein the therapeutically effective dose of the selected medically acceptable fucan is sufficient to increase range of motion in the articulating joint by at least 90% and wherein the method increases the range of motion in the articulating joint by at least 90%.

110. The method of claim 93 wherein the therapeutically effective dose of the selected medically acceptable fucan is sufficient to increase range of motion in the articulating joint by at least 100% and wherein the method increases the range of motion in the articulating joint by at least 100%.

111. The method of any one of claims 93 to 110 wherein the fucan composition is a fucan-low endotoxin composition comprising less than about 0.2 endotoxin units per milligram of the fucan.

112. The method of any one of claims 93 to 111 wherein the fucan composition is a high-molecular-weight fucan wherein the high-molecular-weight fucan has a molecular weight distribution wherein at least about 92% w / w of the molecular weight distribution of the fucan is greater than 100 kDa when measured using an aqueous gel permeation chromatography set up consisting of: one 300 mm analytical gel permeation chromatography column with a 7.8 mm inner diameter packed with hydroxylated polymethacrylate-based gel, having an effective molecular weight range of between about 50 kDa and about 5,000 kDa, one 300 mm analytical gel permeation chromatography column with a 7.8 mm inner diameter packed with hydroxylated polymethacrylate-based gel, having an effective molecular weight range of between about 1 kDa and about 6,000 kDa and one 40 mm guard column with a 6 mm inner diameter packed with hydroxylated polymethacrylate-based gel, the two analytical gel permeation chromatographycolumns and the one guard column contained in a column compartment at about 30 °C; a refractive index detector at about 30 °C; a 0. IM sodium nitrate mobile phase run at 0.6 mL / min; and quantification against a peak molecular weight standard curve consisting of a first dextran standard with a peak molecular weight of about 2,200 kDa, a second dextran standard with a peak molecular weight of between about 720 kDa and about 760 kDa, a third dextran standard with a peak molecular weight between about 470 kDa and about 510 kDa, a fourth dextran standard with a peak molecular weight between about 370 kDa and about 410 kDa, a fifth dextran standard with a peak molecular weight between about 180 kDa and about 220 kDa, and a sixth dextran standard with a peak molecular weight between about 40 kDa and 55 kDa.

113. The method of any one of claims 93 to 112 wherein the fucan composition is a medically acceptable high-sulfate fucan having a sulfate content of between 20% w / w and 55% w / w.

114. The method of any one of claims 93 to 113 wherein the fucan comprises a purified and modified fucan polymeric structure and counterions, wherein the purified and modified fucan polymeric structure consists essentially of fucose, galactose and sulfate, and wherein the purified and modified fucan comprises no more than about 17% counterions, and wherein a total content of fucose, galactose, sulfate and counterions of the purified and modified fucan is greater than 97% w / w.

115. The method of any one of claims 93 to 114 wherein fucan composition is in a medically acceptable formulation and the medically acceptable formulation further comprises at least one diluent, carrier or lubricant specific to delivery of the medically acceptable fucan composition to an articulating joint.

116. The method of any one of claims 93 to 115 wherein the articulating joint is a multiaxial articulating joint.

117. The method of any one of claims 93 to 115 wherein the articulating joint is a monoaxial articulating joint.

118. The method of any one of claims 93 to 117 wherein the method further comprises administering the dose via an arthroscope.

119. The method of any one of claims 93 to 117 wherein the method further comprises administering the dose via a syringe.

120. The method of any one of claims 93 to 117 wherein the method further comprises administering the dose via a syringe and needle.

121. The method of any one of claims 93 to 120 wherein the dose is in contact with an articulating joint.

122. The method of any one of claims 93 to 121 wherein the dose is inserted into an articulating joint.

123. The method of any one of claims 93 to 122 wherein the articulating joint is a knee.

124. The method of any one of claims 93 to 122 wherein the articulating joint is a shoulder.

125. The method of any one of claims 93 to 122 wherein the articulating joint is a hip.

126. The method of any one of claims 93 to 122 wherein the articulating joint is an intervertebral disc.

127. The method of any one of claims 93 to 122 wherein the articulating joint is a synovial joint.

128. The method of any one of claims 93 to 122 wherein the articulating joint is a hinge joint.

129. The method of any one of claims 93 to 122 wherein the articulating joint is a pivot joint.

130. The method of any one of claims 93 to 122 wherein the articulating joint is a condyloid joint.

131. The method of any one of claims 93 to 122 wherein the articulating joint is a ball and socket joint.

132. The method of any one of claims 93 to 122 wherein the articulating joint is an elbow joint.

133. The method of any one of claims 93 to 122 the articulating joint is an ankle joint.

134. The method of any one of claims 93 to 122 wherein the articulating joint is a finger joint.

135. The method of any one of claims 93 to 134 wherein the articulating joint comprises a ligament.

136. The method of any one of claims 93 to 135 wherein the articulating joint comprises a tendon.

137. The method of any one of claims 93 to 136 wherein the selected therapeutically effective dose of the medically acceptable fucan composition is administered to the articulating joint via an arthroscope.

138. The method of any one of claims 93 to 137 wherein the selected therapeutically effective dose of the medically acceptable fucan composition is administered to the articulating joint during an arthroscopic procedure.

139. The method of any one of claims 93 to 137 wherein the selected therapeutically effective dose of the medically acceptable fucan composition is administered to the articulating joint after an arthroscopic procedure.

140. The method of any one of claims 93 to 136 wherein the selected therapeutically effective dose of the medically acceptable fucan composition is administered to the articulating joint during an arthroplasty.

141. The method of any one of claims 93 to 136 wherein the selected therapeutically effective dose of the medically acceptable fucan composition is administered to the articulating joint after an arthroplasty.

142. The method of any one of claims 93 to 141 wherein the selected therapeutically effective dose of the medically acceptable fucan composition is administered to the articulating joint during manipulation of the articulating joint with anesthesia.

143. The method of any one of claims 93 to 141 wherein the selected therapeutically effective dose of the medically acceptable fucan composition is administered to the articulating joint after manipulation of the articulating joint without anesthesia.

144. The method of any one of claims 93 to 143 wherein the therapeutically effective dose is in a medically acceptable formulation and the comprises 2.5 mg of the medically acceptable fucan.

145. The method of any one of claims 93 to 143 wherein the therapeutically effective dose is in a medically acceptable formulation and the comprises 5 mg of the medically acceptable fucan.

146. The method of any one of claims 93 to 143 wherein the therapeutically effective dose is in a medically acceptable formulation and the comprises 10 mg of the medically acceptable fucan.

147. The method of any one of claims 93 to 143 wherein the therapeutically effective dose is in a medically acceptable formulation and the comprises 15 mg of the medically acceptable fucan.

148. The method of any one of claims 93 to 143 wherein the therapeutically effective dose is in a medically acceptable formulation and the comprises 20 mg of the medically acceptable fucan.

149. The method of any one of claims 93 to 143 wherein the therapeutically effective dose is in a medically acceptable formulation and the comprises 25 mg of the medically acceptable fucan.

150. The method of any one of claims 93 to 143 wherein the therapeutically effective dose is in a medically acceptable formulation and the comprises 50 mg of the medically acceptable fucan.

151. The method of any one of claims 93 to 143 wherein the therapeutically effective dose is in a medically acceptable formulation and the comprises 100 mg of the medically acceptable fucan.

152. The method of any one of claims 93 to 143 wherein the therapeutically effective dose is in a medically acceptable formulation and the comprises 150 mg of the medically acceptable fucan.

153. The method of any one of claims 93 to 143 wherein the therapeutically effective dose is in a medically acceptable formulation and the comprises 200 mg of the medically acceptable fucan.

154. The method of any one of claims 93 to 143 wherein the therapeutically effective dose is in a medically acceptable formulation and the comprises 250 mg of the medically acceptable fucan.

155. The method of any one of claims 93 to 143 wherein the therapeutically effective dose is in a medically acceptable formulation and the medically acceptable formulation is in 1 mL of solution containing the medically acceptable fucan.

156. The method of any one of claims 93 to 143 wherein the therapeutically effective dose is in a medically acceptable formulation and the medically acceptable formulation is in 2 mL of solution containing the medically acceptable fucan.

157. The method of any one of claims 93 to 143 wherein the therapeutically effective dose is in a medically acceptable formulation and the medically acceptable formulation is in 3 mL of solution containing the medically acceptable fucan.

158. The method of any one of claims 93 to 143 wherein the therapeutically effective dose is in a medically acceptable formulation and the medically acceptable formulation is in 4 mL of solution containing the medically acceptable fucan.

159. The method of any one of claims 93 to 143 wherein the therapeutically effective dose is in a medically acceptable formulation and the medically acceptable formulation is in 5 mL of solution containing the medically acceptable fucan.

160. The method of any one of claims 93 to 143 wherein the therapeutically effective dose is in a medically acceptable formulation and the medically acceptable formulation is in 10 mL of solution containing the medically acceptable fucan.

161. The method of any one of claims 93 to 143 wherein the therapeutically effective dose is in a medically acceptable formulation and the medically acceptable formulation is in 15 mL of solution containing the medically acceptable fucan.

162. The method of any one of claims 93 to 143 wherein the therapeutically effective dose is in a medically acceptable formulation and the medically acceptable formulation is in 25 mL of solution containing the medically acceptable fucan.

163. The method of any one of claims 93 to 143 wherein the therapeutically effective dose is in a medically acceptable formulation and the medically acceptable formulation is in 50 mL of solution containing the medically acceptable fucan.

164. The method of any one of claims 93 to 163 wherein the articulating joint is an animal articulating joint.

165. The method of any one of claims 93 to 163 wherein the articulating joint is a human articulating joint.

166. A system comprising an arthroscope containing a therapeutically effective dose of a selected medically acceptable fucan composition, the dose selected for and sufficient to increase range of motion in an articulating joint having a limited range of motion.

167. A system comprising a syringe containing a therapeutically effective dose of a selected medically acceptable fucan composition, the dose selected for and sufficient to increase range of motion in an articulating joint having a limited range of motion.

168. A system comprising a syringe and needle containing a therapeutically effective dose of a selected medically acceptable fucan composition, the dose selected for and sufficient to increase range of motion in an articulating joint having a limited range of motion.

169. The system of any of claim 166 to 168 wherein the system further comprises labelling or instructions for use of the system to be administered to an articulating joint having a limited range of motion in order to increase the range of motion of the articulating joint.

170. The system of any of claim 166 to 168 wherein the system is configured for a human articulating joint.

171. The system of any one of claims 166 to 170 wherein the therapeutically effective dose of the selected medically acceptable fucan is sufficient to increase range of motion in the articulating joint by at least 5%.

172. The system of any one of claims 166 to 170 wherein the therapeutically effective dose of the selected medically acceptable fucan is sufficient to increase range of motion in the articulating joint by at least 10%,173. The system of any one of claims 166 to 170 wherein the therapeutically effective dose of the selected medically acceptable fucan is sufficient to increase range of motion in the articulating joint by at least 15%.

174. The system of any one of claims 166 to 170 wherein the therapeutically effective dose of the selected medically acceptable fucan is sufficient to increase range of motion in the articulating joint by at least 20%.

175. The system of any one of claims 166 to 170 wherein the therapeutically effective dose of the selected medically acceptable fucan is sufficient to increase range of motion in the articulating joint by at least 25%.

176. The system of any one of claims 166 to 170 wherein the therapeutically effective dose of the selected medically acceptable fucan is sufficient to increase range of motion in the articulating joint by at least 28%.

177. The system of any one of claims 166 to 170 wherein the therapeutically effective dose of the selected medically acceptable fucan is sufficient to increase range of motion in the articulating joint by at least 30%.

178. The system of any one of claims 166 to 170 wherein the therapeutically effective dose of the selected medically acceptable fucan is sufficient to increase range of motion in the articulating joint by at least 35%.

179. The system of any one of claims 166 to 170 wherein the therapeutically effective dose of the selected medically acceptable fucan is sufficient to increase range of motion in the articulating joint by at least 40%.

180. The system of any one of claims 166 to 170 wherein the therapeutically effective dose of the selected medically acceptable fucan is sufficient to increase range of motion in the articulating joint by at least 42%.

181. The system of any one of claims 166 to 170 wherein the therapeutically effective dose of the selected medically acceptable fucan is sufficient to increase range of motion in the articulating joint by at least 45%.

182. The system of any one of claims 166 to 170 wherein the therapeutically effective dose of the selected medically acceptable fucan is sufficient to increase range of motion in the articulating joint by at least 50%.

183. The system of any one of claims 166 to 170 wherein the therapeutically effective dose of the selected medically acceptable fucan is sufficient to increase range of motion in the articulating joint by at least 60%.

184. The system of any one of claims 166 to 170 wherein the therapeutically effective dose of the selected medically acceptable fucan is sufficient to increase range of motion in the articulating joint by at least 70%.

185. The system of any one of claims 166 to 170 wherein the therapeutically effective dose of the selected medically acceptable fucan is sufficient to increase range of motion in the articulating joint by at least 80%.

186. The system of any one of claims 166 to 170 wherein the therapeutically effective dose of the selected medically acceptable fucan is sufficient to increase range of motion in the articulating joint by at least 90%.

187. The system of any one of claims 166 to 170 wherein the therapeutically effective dose of the selected medically acceptable fucan is sufficient to increase range of motion in the articulating joint by at least 100%.

188. The system of any one of claims 166 to 187 wherein the fucan composition is a fucan-low endotoxin composition comprising less than about 0.2 endotoxin units per milligram of the fucan.

189. The system of any one of claims 166 to 188 wherein the fucan composition is a high- molecular-weight fucan wherein the high-molecular-weight fucan has a molecular weight distribution wherein at least about 92% w / w of the molecular weight distribution of the fucan is greater than 100 kDa when measured using an aqueous gel permeation chromatography set up consisting of: one 300 mm analytical gel permeation chromatography column with a 7.8 mm inner diameter packed with hydroxylated polymethacrylate-based gel, having an effective molecular weight range of between about 50 kDa and about 5,000 kDa, one 300 mm analytical gel permeation chromatography column with a 7.8 mm inner diameter packed with hydroxylated polymethacrylate-based gel, having an effective molecular weight range of between about 1 kDa and about 6,000 kDa and one 40 mm guard column with a 6 mm inner diameter packed with hydroxylated polymethacrylate-based gel, the two analytical gel permeation chromatography columns and the one guard column contained in a column compartment at about 30 °C; a refractive index detector at about 30 °C; a 0. IM sodium nitrate mobile phase run at 0.6 mL / min; and quantification against a peak molecular weight standard curve consisting of a first dextran standard with a peak molecular weight of about 2,200 kDa, a second dextran standard with a peak molecular weight of between about 720 kDa and about 760 kDa, a third dextran standard with a peak molecular weight between about 470 kDa and about 510 kDa, a fourth dextran standard with a peak molecular weight between about 370 kDa and about 410 kDa, a fifth dextran standard with a peak molecular weight between about 180 kDa and about 220 kDa, and a sixth dextran standard with a peak molecular weight between about 40 kDa and 55 kDa.

190. The system of any one of claims 166 to 189 wherein the fucan composition is a medically acceptable high-sulfate fucan having a sulfate content of between 20% w / w and 55% w / w.

191. The system of any one of claims 166 to 190 wherein the fucan comprises a purified and modified fucan polymeric structure and counterions, wherein the purified and modified fucan polymeric structure consists essentially of fucose, galactose and sulfate, and wherein the purified and modified fucan comprises no more than about 17% counterions, andwherein a total content of fucose, galactose, sulfate and counterions of the purified and modified fucan is greater than 97% w / w.

192. The system of any one of claims 166 to 191 wherein fucan composition is in a medically acceptable formulation and the medically acceptable formulation further comprises at least one diluent, carrier or lubricant specific to delivery of the medically acceptable fucan composition to an articulating joint.

193. The system of any one of claims 166 to 192 wherein the system is configured to administer the dose to a multiaxial articulating joint.

194. The system of any one of claims 166 to 192 wherein the system is configured to administer the dose to a monoaxial articulating joint.

195. The system of any one of claims 166 to 194 wherein the system is configured to administer the dose to a knee.

196. The system of any one of claims 166 to 194 wherein the system is configured to administer the dose to a shoulder.

197. The system of any one of claims 166 to 194 wherein the system is configured to administer the dose to a hip.

198. The system of any one of claims 166 to 194 wherein the system is configured to administer the dose to an intervertebral disc.

199. The system of any one of claims 166 to 194 wherein the system is configured to administer the dose to a synovial joint.

200. The system of any one of claims 166 to 194 wherein the system is configured to administer the dose to a hinge joint.

201. The system of any one of claims 166 to 194 wherein the system is configured to administer the dose to a pivot joint.

202. The system of any one of claims 166 to 194 wherein the system is configured to administer the dose to a condyloid joint.

203. The system of any one of claims 166 to 194 wherein the system is configured to administer the dose to a ball and socket joint.

204. The system of any one of claims 166 to 194 wherein the system is configured to administer the dose to an elbow joint.

205. The system of any one of claims 166 to 194 wherein the system is configured to administer the dose to an ankle joint.

206. The system of any one of claims 166 to 194 wherein the system is configured to administer the dose to a finger joint.

207. The system of any one of claims 166 to 206 wherein the articulating joint comprises a ligament.

208. The system of any one of claims 166 to 206 wherein the articulating joint comprises a tendon.

209. The system of any one of claims 166 to 206 wherein the therapeutically effective dose comprises 2.5 mg of the medically acceptable fucan.

210. The system of any one of claims 166 to 206 wherein the therapeutically effective dose comprises 5 mg of the medically acceptable fucan.

211. The system of any one of claims 166 to 206 wherein the therapeutically effective dose comprises 10 mg of the medically acceptable fucan.

212. The system of any one of claims 166 to 206 wherein the therapeutically effective dose comprises 15 mg of the medically acceptable fucan.

213. The system of any one of claims 166 to 206 wherein the therapeutically effective dose comprises 20 mg of the medically acceptable fucan.

214. The system of any one of claims 166 to 206 wherein the therapeutically effective dose comprises 25 mg of the medically acceptable fucan.

215. The system of any one of claims 166 to 206 wherein the therapeutically effective dose comprises 50 mg of the medically acceptable fucan.

216. The system of any one of claims 166 to 206 wherein the therapeutically effective dose comprises 100 mg of the medically acceptable fucan.

217. The system of any one of claims 166 to 206 wherein the therapeutically effective dose comprises 150 mg of the medically acceptable fucan.

218. The system of any one of claims 166 to 206 wherein the therapeutically effective dose comprises 200 mg of the medically acceptable fucan.

219. The system of any one of claims 166 to 206 wherein the therapeutically effective dose comprises 250 mg of the medically acceptable fucan.

220. The system of any one of claims 166 to 206 wherein the therapeutically effective dose is in a medically acceptable formulation and the medically acceptable formulation is in 1 mL of solution containing the medically acceptable fucan.

221. The system of any one of claims 166 to 206 wherein the therapeutically effective dose is in a medically acceptable formulation and the medically acceptable formulation is in 2 mL of solution containing the medically acceptable fucan.

222. The system of any one of claims 166 to 206 wherein the therapeutically effective dose is in a medically acceptable formulation and the medically acceptable formulation is in 3 mL of solution containing the medically acceptable fucan.

223. The system of any one of claims 166 to 206 wherein the therapeutically effective dose is in a medically acceptable formulation and the medically acceptable formulation is in 4 mL of solution containing the medically acceptable fucan.

224. The system of any one of claims 166 to 206 wherein the therapeutically effective dose is in a medically acceptable formulation and the medically acceptable formulation is in 5 mL of solution containing the medically acceptable fucan.

225. The system of any one of claims 166 to 206 wherein the therapeutically effective dose is in a medically acceptable formulation and the medically acceptable formulation is in 10 mL of solution containing the medically acceptable fucan.

226. The system of any one of claims 166 to 206 wherein the therapeutically effective dose is in a medically acceptable formulation and the medically acceptable formulation is in 15 mL of solution containing the medically acceptable fucan.

227. The system of any one of claims 166 to 206 wherein the therapeutically effective dose is in a medically acceptable formulation and the medically acceptable formulation is in 25 mL of solution containing the medically acceptable fucan.

228. The system of any one of claims 166 to 206 wherein the therapeutically effective dose is in a medically acceptable formulation and the medically acceptable formulation is in 50 mL of solution containing the medically acceptable fucan.

229. The system of any one of claims 166 to 228 wherein the system is configured to administer the dose to an animal articulating joint.

230. The system of any one of claims 166 to 229 wherein the system is configured to administer the dose to a human articulating joint.

231. A method of inhibiting decrease of range of motion of an articulating joint, the method comprising:- identifying that the articulating joint has an anticipated decrease in range of motion due to a specific identified cause,- selecting a therapeutically effective dose of a medically acceptable fucan composition to provide a selected therapeutically effective dose of a medically acceptable fucan sufficient to inhibit the decrease of the range of motion in the articulating joint due to the specific identified cause,- administering to the articulating joint the selected therapeutically effective dose of the medically acceptable fucan composition in order to prevent the decrease of the range of motion of the articulating joint due to the specific identified cause.

232. The method of claim 231 wherein the therapeutically effective dose of the medically acceptable fucan is sufficient to inhibit decrease of range of motion in the articulating joint233. The method of claim 231 wherein the therapeutically effective dose of the medically acceptable fucan is sufficient to prevent decrease of range of motion in the articulating joint234. The method of any one of claims 231 to 233 wherein the therapeutically effective dose of the medically acceptable fucan is sufficient to inhibit decrease of range of motion in the articulating joint by at least 5% and wherein the method inhibits decrease of range of motion in the articulating joint by at least 5%.

235. The method of any one of claims 231 to 233 wherein the therapeutically effective dose of the medically acceptable fucan is sufficient to inhibit decrease of range of motion in the articulating joint by at least 10% and wherein the method inhibits decrease of range of motion in the articulating joint by at least 10%.

236. The method of any one of claims 231 to 233 wherein the therapeutically effective dose of the medically acceptable fucan is sufficient to inhibit decrease of range of motion in the articulating joint by at least 15% and wherein the method inhibits decrease of range of motion in the articulating joint by at least 15%.

237. The method of any one of claims 231 to 233 wherein the therapeutically effective dose of the medically acceptable fucan is sufficient to inhibit decrease of range of motion in the articulating joint by at least 20% and wherein the method inhibits decrease of range of motion in the articulating joint by at least 20%.

238. The method of any one of claims 231 to 233 wherein the therapeutically effective dose of the medically acceptable fucan is sufficient to inhibit decrease of range of motion in the articulating joint by at least 25% and wherein the method inhibits decrease of range of motion in the articulating joint by at least 25%.

239. The method of any one of claims 231 to 233 wherein the therapeutically effective dose of the medically acceptable fucan is sufficient to inhibit decrease of range of motion in the articulating joint by at least 28% and wherein the method inhibits decrease of range of motion in the articulating joint by at least 28%.

240. The method of any one of claims 231 to 233 wherein the therapeutically effective dose of the medically acceptable fucan is sufficient to inhibit decrease of range of motion in the articulating joint by at least 30% and wherein the method inhibits decrease of range of motion in the articulating joint by at least 30%.

241. The method of any one of claims 231 to 233 wherein the therapeutically effective dose of the medically acceptable fucan is sufficient to inhibit decrease of range of motion in the articulating joint by at least 35% and wherein the method inhibits decrease of range of motion in the articulating joint by at least 35%.

242. The method of any one of claims 231 to 233 wherein the therapeutically effective dose of the medically acceptable fucan is sufficient to inhibit decrease of range of motion in the articulating joint by at least 40% and wherein the method inhibits decrease of range of motion in the articulating joint by at least 40%.

243. The method of any one of claims 231 to 233 wherein the therapeutically effective dose of the medically acceptable fucan is sufficient to inhibit decrease of range of motion in the articulating joint by at least 42% and wherein the method inhibits decrease of range of motion in the articulating joint by at least 42%.

244. The method of any one of claims 231 to 233 wherein the therapeutically effective dose of the medically acceptable fucan is sufficient to inhibit decrease of range of motion in the articulating joint by at least 45% and wherein the method inhibits decrease of range of motion in the articulating joint by at least 45%.

245. The method of any one of claims 231 to 233 wherein the therapeutically effective dose of the medically acceptable fucan is sufficient to inhibit decrease of range of motion in thearticulating joint by at least 50% and wherein the method inhibits decrease of range of motion in the articulating joint by at least 50%.

246. The method of any one of claims 231 to 233 wherein the therapeutically effective dose of the medically acceptable fucan is sufficient to inhibit decrease of range of motion in the articulating joint by at least 60% and wherein the method inhibits decrease of range of motion in the articulating joint by at least 60%.

247. The method of any one of claims 231 to 233 wherein the therapeutically effective dose of the medically acceptable fucan is sufficient to inhibit decrease of range of motion in the articulating joint by at least 70% and wherein the method inhibits decrease of range of motion in the articulating joint by at least 70%.

248. The method of any one of claims 231 to 233 wherein the therapeutically effective dose of the medically acceptable fucan is sufficient to inhibit decrease of range of motion in the articulating joint by at least 80% and wherein the method inhibits decrease of range of motion in the articulating joint by at least 80%.

249. The method of any one of claims 231 to 233 wherein the therapeutically effective dose of the medically acceptable fucan is sufficient to inhibit decrease of range of motion in the articulating joint by at least 90% and wherein the method inhibits decrease of range of motion in the articulating joint by at least 90%.

250. The method of any one of claims 231 to 233 wherein the therapeutically effective dose of the medically acceptable fucan is sufficient to inhibit decrease of range of motion in the articulating joint by at least 100% and wherein the method inhibits decrease of range of motion in the articulating joint by at least 100%.

251. The method of any one of claims 231 to 250 wherein the fucan composition is a fucan-low endotoxin composition comprising less than about 0.2 endotoxin units per milligram of the fucan.

252. The method of any one of claims 231 to 251 wherein the fucan composition is a high- molecular-weight fucan wherein the high-molecular-weight fucan has a molecular weight distribution wherein at least about 92% w / w of the molecular weight distribution of the fucan is greater than 100 kDa when measured using an aqueous gel permeation chromatography set up consisting of:one 300 mm analytical gel permeation chromatography column with a 7.8 mm inner diameter packed with hydroxylated polymethacrylate-based gel, having an effective molecular weight range of between about 50 kDa and about 5,000 kDa, one 300 mm analytical gel permeation chromatography column with a 7.8 mm inner diameter packed with hydroxylated polymethacrylate-based gel, having an effective molecular weight range of between about 1 kDa and about 6,000 kDa and one 40 mm guard column with a 6 mm inner diameter packed with hydroxylated polymethacrylate-based gel, the two analytical gel permeation chromatography columns and the one guard column contained in a column compartment at about 30 °C; a refractive index detector at about 30 °C; a 0. IM sodium nitrate mobile phase run at 0.6 mL / min; and quantification against a peak molecular weight standard curve consisting of a first dextran standard with a peak molecular weight of about 2,200 kDa, a second dextran standard with a peak molecular weight of between about 720 kDa and about 760 kDa, a third dextran standard with a peak molecular weight between about 470 kDa and about 510 kDa, a fourth dextran standard with a peak molecular weight between about 370 kDa and about 410 kDa, a fifth dextran standard with a peak molecular weight between about 180 kDa and about 220 kDa, and a sixth dextran standard with a peak molecular weight between about 40 kDa and 55 kDa.

253. The method of any one of claims 231 to 252 wherein the fucan composition is a medically acceptable high-sulfate fucan having a sulfate content of between 20% w / w and 55% w / w.

254. The method of any one of claims 231 to 253 wherein the fucan comprises a purified and modified fucan polymeric structure and counterions, wherein the purified and modified fucan polymeric structure consists essentially of fucose, galactose and sulfate, and wherein the purified and modified fucan comprises no more than about 17% counterions, and wherein a total content of fucose, galactose, sulfate and counterions of the purified and modified fucan is greater than 97% w / w.

255. The method of any one of claims 231 to 254 wherein fucan composition is in a medically acceptable formulation and the medically acceptable formulation further comprises at leastone diluent, carrier or lubricant specific to delivery of the medically acceptable fucan composition to an articulating joint.

256. The method of any one of claims 231 to 255 wherein the method further comprises administering the dose to a multiaxial articulating joint.

257. The method of any one of claims 231 to 255 wherein the method further comprises administering the dose to a monoaxial articulating joint.

258. The method of any one of claims 231 to 257 wherein the method further comprises administering the dose via an arthroscope.

259. The method of any one of claims 231 to 257 wherein the method further comprises administering the dose via a syringe.

260. The method of any one of claims 231 to 257 wherein the method further comprises administering the dose via a syringe and needle.

261. The method of any one of claims 231 to 260 wherein the dose is administered to contact an articulating joint.

262. The method of any one of claims 231 to 260 wherein the dose is inserted into an articulating joint.

263. The method of any one of claims 231 to 262 wherein the method further comprises administering the dose to a knee.

264. The method of any one of claims 231 to 262 wherein the method further comprises administering the dose to a shoulder.

265. The method of any one of claims 231 to 262 wherein the method further comprises administering the dose to a hip.

266. The method of any one of claims 231 to 262 wherein the method further comprises administering the dose to an intervertebral disc.

267. The method of any one of claims 231 to 262 wherein the method further comprises administering the dose to a synovial joint.

268. The method of any one of claims 231 to 262 wherein the method further comprises administering the dose to a hinge joint.

269. The method of any one of claims 231 to 262 wherein the method further comprises administering the dose to a pivot joint.

270. The method of any one of claims 231 to 262 wherein the method further comprises administering the dose to a condyloid joint.

271. The method of any one of claims 231 to 262 wherein the method further comprises administering the dose to a ball and socket joint.

272. The method of any one of claims 231 to 262 wherein the method further comprises administering the dose to an elbow joint.

273. The method of any one of claims 231 to 262 wherein the method further comprises administering the dose to an ankle joint.

274. The method of any one of claims 231 to 262 wherein the method further comprises administering the dose to a finger joint.

275. The method of any one of claims 231 to 262 wherein the articulating joint comprises a ligament.

276. The method of any one of claims 231 to 262 wherein the articulating joint comprises a tendon.

277. The method of any one of claims 231 to 276 wherein the selected therapeutically effective dose of the medically acceptable fucan composition is administered to the articulating joint via an arthroscope.

278. The method of any one of claims 231 to 276 wherein the selected therapeutically effective dose of the medically acceptable fucan composition is administered to the articulating joint during an arthroscopic procedure.

279. The method of any one of claims 231 to 276 wherein the selected therapeutically effective dose of the medically acceptable fucan composition is administered to the articulating joint after an arthroscopic procedure.

280. The method of any one of claims 231 to 276 wherein the selected therapeutically effective dose of the medically acceptable fucan composition is administered to the articulating joint during an arthroplasty.

281. The method of any one of claims 231 to 276 wherein the selected therapeutically effective dose of the medically acceptable fucan composition is administered to the articulating joint after an arthroplasty.

282. The method of any one of claims 231 to 281 wherein the selected therapeutically effective dose of the medically acceptable fucan composition is administered to the articulating joint during manipulation of the articulating joint with anesthesia.

283. The method of any one of claims 231 to 281 wherein the selected therapeutically effective dose of the medically acceptable fucan composition is administered to the articulating joint after manipulation of the articulating joint without anesthesia.

284. The method of any one of claims 231 to 283 wherein the therapeutically effective dose comprises 2.5 mg of the medically acceptable fucan.

285. The method of any one of claims 231 to 283 wherein the therapeutically effective dose comprises 5 mg of the medically acceptable fucan.

286. The method of any one of claims 231 to 283 wherein the therapeutically effective dose comprises 10 mg of the medically acceptable fucan.

287. The method of any one of claims 231 to 283 wherein the therapeutically effective dose comprises 15 mg of the medically acceptable fucan.

288. The method of any one of claims 231 to 283 wherein the therapeutically effective dose comprises 20 mg of the medically acceptable fucan.

289. The method of any one of claims 231 to 283 wherein the therapeutically effective dose comprises 25 mg of the medically acceptable fucan.

290. The method of any one of claims 231 to 283 wherein the therapeutically effective dose comprises 50 mg of the medically acceptable fucan.

291. The method of any one of claims 231 to 283 wherein the therapeutically effective dose comprises 100 mg of the medically acceptable fucan.

292. The method of any one of claims 231 to 283 wherein the therapeutically effective dose comprises 150 mg of the medically acceptable fucan.

293. The method of any one of claims 231 to 283 wherein the therapeutically effective dose comprises 200 mg of the medically acceptable fucan.

294. The method of any one of claims 231 to 283 wherein the therapeutically effective dose comprises 250 mg of the medically acceptable fucan.

295. The method of any one of claims 231 to 283 wherein the therapeutically effective dose is in a medically acceptable formulation and the medically acceptable formulation is in 1 mL of solution containing the medically acceptable fucan.

296. The method of any one of claims 231 to 283 wherein the therapeutically effective dose is in a medically acceptable formulation and the medically acceptable formulation is in 2 mL of solution containing the medically acceptable fucan.

297. The method of any one of claims 231 to 283 wherein the therapeutically effective dose is in a medically acceptable formulation and the medically acceptable formulation is in 3 mL of solution containing the medically acceptable fucan.

298. The method of any one of claims 231 to 283 wherein the therapeutically effective dose is in a medically acceptable formulation and the medically acceptable formulation is in 4 mL of solution containing the medically acceptable fucan.

299. The method of any one of claims 231 to 283 wherein the therapeutically effective dose is in a medically acceptable formulation and the medically acceptable formulation is in 5 mL of solution containing the medically acceptable fucan.

300. The method of any one of claims 231 to 283 wherein the therapeutically effective dose is in a medically acceptable formulation and the medically acceptable formulation is in 10 mL of solution containing the medically acceptable fucan.

301. The method of any one of claims 231 to 283 wherein the therapeutically effective dose is in a medically acceptable formulation and the medically acceptable formulation is in 15 mL of solution containing the medically acceptable fucan.

302. The method of any one of claims 231 to 283 wherein the therapeutically effective dose is in a medically acceptable formulation and the medically acceptable formulation is in 25 mL of solution containing the medically acceptable fucan.

303. The method of any one of claims 231 to 283 wherein the therapeutically effective dose is in a medically acceptable formulation and the medically acceptable formulation is in 50 mL of solution containing the medically acceptable fucan.

304. The method of any one of claims 231 to 303 wherein the method further comprises administering the dose to an animal articulating joint.

305. The method of any one of claims 231 to 303 wherein the method further comprises administering the dose to a human articulating joint.

306. A therapeutically effective dose comprising a medically acceptable fucan composition sufficient to increase range of motion in an articulating joint having a limited range of motion prior to the administering, fucan composition is in a medically acceptable formulation andthe medically acceptable formulation further comprises comprising at least one diluent, carrier or lubricant specific to delivery of the medically acceptable fucan composition to an articulating joint, and wherein the dose is located in a container having labelling or instructions for use of the dose to be administered to the articulating joint having the limited range of motion in order to increase the range of the motion articulating joint.

307. The therapeutically effective dose of claim 306 wherein the dose is configured to be administered to an animal articulating joint.

308. The therapeutically effective dose of claim 306 wherein the dose is configured to be administered to a human articulating joint.

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